Understanding and safely managing paranoid personality disorder

by Dr Andrew Carroll and Dr Clare McInerney

 

Last updated: July 2020

 

The focus of this module is paranoid personality disorder (PPD), a condition in which mistrust of others is the cardinal feature. PPD is a somewhat neglected topic, and is often the subject of diagnostic confusion and therapeutic pessimism. The research base on the disorder remains sparse, however an understanding of underlying psychological processes can assist with its assessment and treatment.

 

Although a certain degree of mistrust with respect to the intentions of others is normal, particularly in certain social situations, suspiciousness may become maladaptive. Clinically significant paranoid features are found in a variety of contexts: in previously healthy individuals subjected to abnormal stress; in mental illness; and in those with personality disorders.

 

This module presents a summary of the key diagnostic issues relating to PPD and describes the various psychological and social processes mooted to be central to the genesis of paranoid thinking and behaviours. The evidence relating to PPD and violence risk is then summarised and clinically useful guidance for the safe treatment of sufferers is outlined.

 

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